Gerald Jay Broock, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD27913 Issued in OR

Practice address

123 NW 12TH Ave
Apt. 1426
Portland, OR 97209-4143

Phone

(757) 561-6056

NPI assigned

Dec 7, 2011

Last updated

Dec 7, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1780952515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 NW 12TH AVE",
            "address_2": "APT. 1426",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094143",
            "telephone_number": "757-561-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 NW 12TH AVE",
            "address_2": "APT. 1426",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094143",
            "telephone_number": "757-561-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOCK",
        "first_name": "GERALD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD27913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kent Bromenschenkel
• William Bradford Bronec, M.D.
• Dustin M Bronsdon, AU.D.
• Karen Bronson, PHARMD
• Nicholas Bronson
• Anna Brook, L. AC.
• Christy Brook
• Brooke Hammond Counseling, LLC
• Brooke Psychologists, LLC
• Brooke Seright Acupuncture LLC (Vetiver Acupunture)

• Orthopaedic Surgery Physician in Portland, OR
• Providers in Portland, OR by specialty
• Orthopaedic Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.